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Insurance Verification Clerk

Treating patients like family

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Insurance Verification Clerk

Tucson, Arizona Oro Valley Surgical Suites (13856)
Category Business Office Job ID 70093-147
Status Full-Time/Regular
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Oro Valley Surgical Suites is seeking a detail-oriented and highly organized Insurance Verification Clerk to join our administrative team. This role plays a crucial part in ensuring a seamless patient experience by verifying insurance coverage and eligibility prior to scheduled surgical procedures. The ideal candidate will be committed to accuracy, confidentiality, and top-tier service in a fast-paced ambulatory surgical environment.


Required Skills:

Key Responsibilities:

  • Verify insurance eligibility and benefits for scheduled procedures using electronic systems or by contacting payers directly

  • Confirm authorizations, referrals, and pre-certifications are in place as required by payer guidelines

  • Communicate effectively with patients regarding insurance coverage, out-of-pocket estimates, and any requirements prior to surgery

  • Coordinate with billing, scheduling, and clinical teams to ensure all necessary information is accurate and complete

  • Enter and update insurance and demographic information in the patient management system

  • Identify and resolve discrepancies related to insurance information and patient accounts

  • Maintain up-to-date knowledge of insurance plans, billing guidelines, and regulatory requirements

  • Respond to inquiries from patients, payers, and internal staff in a timely and professional manner

  • Assist in identifying trends in claim denials related to insurance verification errors

  • Support the Business Office team with additional administrative tasks as needed


Qualifications:

  • High school diploma or equivalent required; associate degree or certification in medical billing/coding a plus

  • Minimum 1–2 years of experience in insurance verification, preferably in a surgical or outpatient setting

  • Familiarity with major insurance carriers, Medicare, Medicaid, and managed care plans

  • Knowledge of CPT/ICD coding and medical terminology

  • Proficiency with EMR systems and eligibility verification platforms (e.g., Availity, Navinet, etc.)

  • Excellent attention to detail, communication, and organizational skills

  • Ability to work independently and collaboratively in a team-focused environment

  • Demonstrated commitment to maintaining patient confidentiality and HIPAA compliance

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